“Location, location, location” is not just a saying in real estate, it can also apply to cosmetic breast surgery. In particular, it is the location of the nipple (further south) that often brings a woman in to see a cosmetic surgeon. As women age, nurse babies, gain and lose weight etc… their breasts change. This is all normal, but some women are unhappy with the stretched skin and sagging that may occur.

This can be true for women with large or small breasts and helps determine whether she chooses a breast lift, either alone or in combination with another cosmetic procedure like an augmentation or a reduction. In our article, Augmentation, Lift or Both?, we discuss breast lifts in the context of breast enlargement. In this article we will discuss breast lifts and breast reductions and why they are often combined.

Breast Lift (Mastopexy)

A breast lift, or mastopexy, is usually done for someone whose nipple is below the breast fold or who has a significant amount of skin below the breast fold. It may also be done to reduce nipple size or for issues with skin irritation under the breast fold.

The procedure involves the removal of excess skin from around the nipple and lower part of the breasts. The nipple may be reduced in size and moved up to a higher position. This can slightly reduce the size of the breast while also decreasing sagging, improving firmness, and giving a more youthful appearance.

Breast Reduction

A breast reduction, or reduction mammaplasty, is a procedure done for women (and men, in fact) who want to reduce the size of their breasts. This may be for cosmetic reasons – perhaps they don’t feel their breasts are in proportion to the rest of their body, or, in the case of men, they want a less feminine appearance. People also pursue breast reduction surgery to alleviate physical symptoms like neck, shoulder, and back pain, headaches, and painful bra strap grooving.

During a breast reduction, breast tissue, including excess fat, skin, and glandular tissue, is removed. The extent of tissue removed depends on the original breast size and the goals of the patient. The surgery includes lifting the breast and repositioning the nipple unless the reduction is done by liposuction alone.

Breast Reduction with Lift

Because larger, heavier breasts are prone to droopiness, a reduction almost always includes a breast lift. According to Dr. Slack, “With any reduction technique, except liposuction-only, the breast is lifted, meaning the droopy lower pole of the breast is elevated so that the breast starts at the breast fold and moves up from there. The nipple/areola complex is elevated along with the breast and is typically made smaller.”

The lift is done for aesthetics, but it is also done for women whose primary complaints are physical symptoms like neck and shoulder pain. This is because the lift and subsequent higher positioning of the breasts significantly improves posture and takes stress off muscles in the neck and shoulders.